Urology Coding Alert

Also, look forward to coding NF visits by time Come January, you'll be faced with several new and revised E/M codes. Since much of your coding relies on E/M codes, save yourself a few headaches and dodge the potential denials by staying ahead of the coding curve. Half the new E/M codes are replacements for codes removed from CPT 2008. For instance, medical team conferences codes 99361 and 99362 have been deleted and replaced by three all-new codes: • 99366 -- Medical team conference with interdisciplinary team of healthcare professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified healthcare professional • 99367 -- Medical team conference with interdisciplinary team of healthcare professionals, patient and/or family not present, 30 minutes or more; participation by physician • 99368 -- ... participation by nonphysician qualified healthcare professional. Take Note of Old vs. New Differences Codes 99366-99368 differ from their predecessors 99361 and 99362 in several ways. Most important, 99366 and 99368 apply to nonphysician healthcare professionals, such as nurse practitioners or physician assistants, says Susan E. Garrison, CHC, PCS, FCS, CCS P, CPAR, CPC, CPC H, executive vice president of Healthcare Consulting Services. Both code descriptors specify a minimum service time of 30 minutes or more, but 99366 also stipulates that the patient and/or family must be present during the conference. Patient presence matters: Many payers, including Medicare, will not reimburse separately for non-face-to-face services -- which means insurers will likely not recognize 99368 (during which the patient and/or family are not present) as a payable service. Payers may choose, however, to accept 99366 if a nonphysician practitioner (NPP) in your practice takes part in a team conference for a patient under your care, as long as the patient and/or family is involved. Code 99367 also requires a service time of 30 or more minutes, but applies when a physician also participates in the team conference. In this case, the patient and/or family is not present. Previously, 99361 and 99362 also described physician participation in a team conference, but because those codes specified "patient not present," Medicare and other payers would not reimburse for the services. Because 99367 likewise is not a face-to-face service, payers will almost definitely not pay for it. Emphasize Documentation With Your Urologist Documentation will be key when reporting team conferences, Garrison says. She suggests that for each service, NPP or physician notes should specify: 1. Who participates in the conference (the specific providers with credentials). Remember, only one same-specialty, same-practice professional may bill per conference. 2. Time of participation. This must begin at the start of the review for an individual patient, and ends when that review concludes. The service must deal with [...]